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  1. Article ; Online: Comment on: Sleeve gastrectomy as a rescue of failed gastric banding: comparison of 1- and 2-step approaches.

    Williford, Michael L / Hechenbleikner, Elizabeth M

    Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

    2020  Volume 16, Issue 9, Page(s) e51–e52

    MeSH term(s) Bariatric Surgery ; Gastrectomy ; Gastroplasty
    Language English
    Publishing date 2020-07-09
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2274243-8
    ISSN 1878-7533 ; 1550-7289
    ISSN (online) 1878-7533
    ISSN 1550-7289
    DOI 10.1016/j.soard.2020.06.019
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  2. Article ; Online: Data explosion during COVID-19: A call for collaboration with the tech industry & data scrutiny.

    Hechenbleikner, Elizabeth M / Samarov, Daniel V / Lin, Ed

    EClinicalMedicine

    2020  Volume 23, Page(s) 100377

    Keywords covid19
    Language English
    Publishing date 2020-05-24
    Publishing country England
    Document type Journal Article
    ISSN 2589-5370
    ISSN (online) 2589-5370
    DOI 10.1016/j.eclinm.2020.100377
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  3. Article ; Online: Surgical readmissions: a method to the madness.

    Hechenbleikner, Elizabeth M / Wick, Elizabeth C

    JAMA surgery

    2014  Volume 149, Issue 4, Page(s) 354–355

    MeSH term(s) Female ; Humans ; Male ; Patient Readmission/statistics & numerical data ; Postoperative Complications/epidemiology ; Quality Assurance, Health Care
    Language English
    Publishing date 2014-04
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2013.4079
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  5. Article ; Online: Data explosion during COVID-19

    Hechenbleikner, Elizabeth M. / Samarov, Daniel V. / Lin, Ed

    EClinicalMedicine

    A call for collaboration with the tech industry & data scrutiny

    2020  Volume 23, Page(s) 100377

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ISSN 2589-5370
    DOI 10.1016/j.eclinm.2020.100377
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Implementation of an Online Intraoperative Assessment of Technical Performance for Surgical Trainees.

    Faber, David A / Hinman, Johanna M / Knauer, Eric M / Hechenbleikner, Elizabeth M / Badell, I Raul / Lin, Edward / Srinivasan, Jahnavi K / Chahine, A Alfred / Papandria, Dominic J

    The Journal of surgical research

    2023  Volume 291, Page(s) 574–585

    Abstract: Introduction: Assessment of surgical resident technical performance is an integral component of any surgical training program. Timely assessment delivered in a structured format is a critical step to enhance technical skills, but residents often report ... ...

    Abstract Introduction: Assessment of surgical resident technical performance is an integral component of any surgical training program. Timely assessment delivered in a structured format is a critical step to enhance technical skills, but residents often report that the quality and quantity of timely feedback received is lacking. Moreover, the absence of written feedback with specificity can allow residents to seemingly progress in their operative milestones as a junior resident, but struggle as they progress into their postgraduate year 3 and above. We therefore designed and implemented a web-based intraoperative assessment tool and corresponding summary "dashboard" to facilitate real-time assessment and documentation of technical performance.
    Materials and methods: A web form was designed leveraging a cloud computing platform and implementing a modified Ottawa Surgical Competency Operating Room Evaluation instrument; this included additional, procedure-specific criteria for select operations. A link to this was provided to residents via email and to all surgical faculty as a Quick Response code. Residents open and complete a portion of the form on a smartphone, then relinquish the device to an attending surgeon who then completes and submits the assessment. The data are then transferred to a secure web-based reporting interface; each resident (together with a faculty advisor) can then access and review all completed assessments.
    Results: The Assessment form was activated in June 2021 and formally introduced to all residents in July 2021, with residents required to complete at least one assessment per month. Residents with less predictable access to operative procedures (night float or Intensive Care Unit) were exempted from the requirement on those months. To date a total of 559 assessments have been completed for operations performed by 56 trainees, supervised by 122 surgical faculty and senior trainees. The mean number of procedures assessed per resident was 10.0 and the mean number per assessor was 4.6. Resident initiation of Intraoperative Assessments has increased since the tool was introduced and scores for technical and nontechnical performance reliably differentiate residents by seniority.
    Conclusions: This novel system demonstrates that an online, resident-initiated technical assessment tool is feasible to implement and scale. This model's requirement that the attending enter performance ratings into the trainee's electronic device ensures that feedback is delivered directly to the trainee. Whether this aspect of our assessment ensures more direct and specific (and therefore potentially actionable) feedback is a focus for future study. Our use of commercial cloud computing services should permit cost-effective adoption of similar systems at other training programs.
    MeSH term(s) Internship and Residency ; Clinical Competence ; Education, Medical, Graduate/methods ; Feedback ; Educational Measurement/methods ; General Surgery/education
    Language English
    Publishing date 2023-08-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2023.07.008
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    Zs.A 178: Show issues Location:
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  7. Article ; Online: Extended postoperative venous thromboembolism prophylaxis after bariatric surgery: a comparison of existing risk-stratification tools and 5-year MBSAQIP analysis.

    Imbus, Joseph R / Jung, Andrew D / Davis, S / Oyefule, Omobolanle O / Patel, Ankit D / Serrot, Federico J / Stetler, Jamil L / Majumdar, Melissa C / Papandria, Dominic / Diller, Maggie L / Srinivasan, Jahnavi K / Lin, Edward / Hechenbleikner, Elizabeth M

    Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

    2023  Volume 19, Issue 8, Page(s) 808–816

    Abstract: ... body mass index threshold of 50 kg/m: Results: Overall, 709,304 patients were identified with a .37% VTE rate ...

    Abstract Background: Venous thromboembolism (VTE) is a leading cause of 30-day mortality after metabolic and bariatric surgery (MBS). Multiple predictive tools exist for VTE risk assessment and extended VTE chemoprophylaxis determination.
    Objective: To review existing risk-stratification tools and compare their predictive abilities.
    Setting: MBSAQIP database.
    Methods: Retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was performed (2015-2019) for primary minimally invasive MBS cases. VTE clinical factors and risk-assessment tools were evaluated: body mass index threshold of 50 kg/m
    Results: Overall, 709,304 patients were identified with a .37% VTE rate. Bariatric-specific tools included multiple predictors: procedure, age, race, gender, operative time, length of stay, heart failure, and dyspnea at rest; operative time was the only variable common to all. The body mass index cutoff and Caprini risk-assessment model had higher sensitivity but lower specificity when compared with the Michigan Bariatric Surgery Collaborative and BariClot tools. While the sensitivity of the tools varied widely and was overall low, the Cleveland Clinic tool had the highest sensitivity. The bariatric-specific tools would have recommended extended prophylaxis for 1.1%-15.6% of patients.
    Conclusions: Existing MBS VTE risk-assessment tools differ widely for inclusion variables, high-risk definition, and predictive performance. Further research and registry inclusion of all significant risk factors are needed to determine the optimal risk-stratified approach for predicting VTE events and determining the need for extended prophylaxis.
    MeSH term(s) Humans ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control ; Quality Improvement ; Retrospective Studies ; Postoperative Complications/etiology ; Anticoagulants/therapeutic use ; Bariatric Surgery/adverse effects ; Bariatric Surgery/methods ; Risk Factors
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-04-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2274243-8
    ISSN 1878-7533 ; 1550-7289
    ISSN (online) 1878-7533
    ISSN 1550-7289
    DOI 10.1016/j.soard.2023.04.329
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    Zs.A 6572: Show issues Location:
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  8. Article ; Online: Does the use of a suction calibration system (SCS) reduce stapler load firings and operative time? A randomized controlled trial comparing use of endoscopic calibration vs. SCS in laparoscopic sleeve gastrectomy.

    Hechenbleikner, Elizabeth / Mou, Danny / Delgado, Victoria / Majumdar, Melissa / Grunewald, Zachary / Fay, Katherine / Hall, Carrie E / Wells, Marcus T / Patel, Ankit / Stetler, Jamil / Serrot, Federico / Srinivasan, Jahnavi / Oyefule, Omobolanle / Diller, Maggie / Davis, Scott / Lin, Edward

    Surgical endoscopy

    2023  Volume 37, Issue 10, Page(s) 7940–7946

    Abstract: ... underwent study enrollment, with an average age of 44 ± 12 years and average BMI of 49 ± 8 kg/m ...

    Abstract Background: It is critical to ensure appropriate and consistent sleeve size and orientation during laparoscopic sleeve gastrectomy (LSG). Various devices are used to achieve this, including weighted rubber bougies, esophagogastroduodenoscopy (EGD), and suction calibration systems (SCS). Prior reports suggest that SCSs may decrease operative time and stapler load firings but are limited by single-surgeon experience and retrospective design. We performed the first randomized controlled trial comparing SCS against EGD in patients undergoing LSG to investigate whether the SCS decreases the number of stapler load firings.
    Methods: This was a randomized, non-blinded study from a single MBSAQIP-accredited academic center. Appropriate LSG candidates ≥ 18 years of age were randomized to EGD or SCS calibration. Exclusion criteria included prior gastric or bariatric surgery, detection of hiatal hernia before surgery, and intraoperative hiatal hernia repair. A randomized block design was employed controlling for body mass index, gender, and race. Seven surgeons employed a standardized LSG operative technique. The primary endpoint was the number of stapler load firings. Secondary endpoints were operative duration, reflux symptoms, and change in total body weight (TBW). Endpoints were analyzed via t-test.
    Results: A total of 125 LSG patients (84% female) underwent study enrollment, with an average age of 44 ± 12 years and average BMI of 49 ± 8 kg/m
    Conclusion: Use of EGD and SCS resulted in a similar number of LSG stapler load firings and operative duration. Additional research is needed to compare LSG calibration devices in different patients and settings to optimize surgical technique.
    MeSH term(s) Humans ; Female ; Adult ; Middle Aged ; Male ; Obesity, Morbid/surgery ; Operative Time ; Calibration ; Retrospective Studies ; Suction ; Laparoscopy/methods ; Gastrectomy/methods ; Treatment Outcome
    Language English
    Publishing date 2023-07-11
    Publishing country Germany
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-023-10251-2
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    Zs.A 2214: Show issues Location:
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  9. Article ; Online: Ketorolac Use Shortens Hospital Length of Stay After Bariatric Surgery: a Single-Center 5-Year Experience.

    Hariri, Kamyar / Hechenbleikner, Elizabeth / Dong, Matthew / Kini, Subhash U / Fernandez-Ranvier, Gustavo / Herron, Daniel M

    Obesity surgery

    2019  Volume 29, Issue 8, Page(s) 2360–2366

    Abstract: Introduction: There has been a recent increased interest in the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ketorolac for post-operative pain management to minimize opioid use and decrease hospital length of stay (LOS). Although NSAID ... ...

    Abstract Introduction: There has been a recent increased interest in the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ketorolac for post-operative pain management to minimize opioid use and decrease hospital length of stay (LOS). Although NSAID use has been controversial following bariatric surgery due to anecdotal concerns for increased gastric bleeding, the impact of ketorolac as an adjunct to opioids needs further investigation on LOS and post-operative complications like bleeding.
    Objective: This study aims to evaluate the impact of post-operative ketorolac use on opioid consumption, LOS, and bleeding risk after bariatric surgery.
    Methods: We retrospectively analyzed a prospectively maintained database of all bariatric surgery patients who either underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass surgery (RYGB) at a tertiary center between 2011 and 2015. Patients were stratified into 2 groups based on post-operative pain control regimen as follows: (1) ketorolac and opioids and (2) opioids alone.
    Results: A total of 1555 patients were identified who underwent either SG (n = 1255) or RYGB (n = 300). The overall LOS was 1.81 ± .059 days for ketorolac-opioid patients vs. 2.09 ± .065 days for opioid-only patients (P < 0.001). Furthermore, the risk of post-operative bleeding was similar between the two groups (P = 0.097).
    Conclusion: Patients who received ketorolac as an adjunct to opioids had a significantly shorter LOS compared to opioid-only patients. Additionally, ketorolac use was not associated with increased risk of post-operative bleeding complications. Therefore, if not contraindicated, ketorolac should be considered routinely for post-operative pain control among bariatric surgery patients.
    MeSH term(s) Adult ; Analgesics, Opioid/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Drug Therapy, Combination ; Female ; Gastrectomy ; Gastric Bypass ; Humans ; Ketorolac/therapeutic use ; Length of Stay/statistics & numerical data ; Male ; Pain, Postoperative/drug therapy ; Retrospective Studies
    Chemical Substances Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Ketorolac (YZI5105V0L)
    Language English
    Publishing date 2019-06-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-018-03636-z
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    Zs.A 3381: Show issues Location:
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  10. Article ; Online: Surgical treatment of acquired rectourethral fistulas: our experience with posterior transrectal transsphincteric approach. Author reply.

    Hechenbleikner, Elizabeth M / Buckley, Jill C / Wick, Elizabeth C

    Diseases of the colon and rectum

    2013  Volume 56, Issue 7, Page(s) e347

    MeSH term(s) Humans ; Reconstructive Surgical Procedures ; Rectal Fistula/surgery ; Urethral Diseases/surgery ; Urinary Fistula/surgery
    Language English
    Publishing date 2013-07
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0b013e318293de59
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